Cherry Kathryn E, Li Jenna D, Brent Rebecca J
Women's Behavioral Health, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA, 15224, USA.
Allegheny Singer Research Institute, Allegheny Health Network, Pittsburgh, PA, 15224, USA.
Arch Womens Ment Health. 2025 Feb;28(1):147-155. doi: 10.1007/s00737-024-01480-y. Epub 2024 Jun 10.
Perinatal Intensive Outpatient Programs (IOPs) address severe perinatal mood and anxiety disorders (PMADs) and mother-infant relationship concerns. Given the impact of PMADs on mothers and infants, rapid transitions to virtual services (telehealth) amid COVID-19, and service expansions to populations in need, it is critical to evaluate how effectively virtual and in-person perinatal IOP services treat PMADs and mother-infant bonding.
This quality-improvement record review examined patient records (n = 361) for a perinatal IOP from May 2016 to July 2023, amid multiple transitions between in-person and virtual services related to COVID-19, influenza, and respiratory syncytial virus. Patients in the completed measures sample (n = 115) completed depression (EPDS), anxiety (GAD-7, PASS), and mother-infant bonding (PBQ) measures over the first 3 weeks of treatment. Patients also anonymously provided program satisfaction ratings and qualitative feedback.
While anxiety and depression symptoms improved similarly across service settings, mother-baby bonding only significantly improved with in-person treatment. Patient symptom outcomes also differed by public/private insurance, race, and number of children. Patients reported high service ratings and overall satisfaction, and available feedback indicates some preference for in-person services.
As perinatal mental health services and IOPs continue to expand, virtual services can similarly address anxiety and depression symptoms and help to reach in-need populations. However, for perinatal IOPs, the core treatment target of mother-infant bonding may be uniquely addressed via in-person services.
围产期强化门诊项目(IOPs)针对严重的围产期情绪和焦虑障碍(PMADs)以及母婴关系问题。鉴于PMADs对母亲和婴儿的影响、在新冠疫情期间迅速转向虚拟服务(远程医疗)以及向有需要的人群扩大服务范围,评估虚拟和面对面的围产期IOP服务治疗PMADs和母婴联结的效果至关重要。
这项质量改进记录审查检查了2016年5月至2023年7月期间一个围产期IOP的患者记录(n = 361),在此期间与新冠疫情、流感和呼吸道合胞病毒相关的面对面和虚拟服务之间多次转换。完成测量样本中的患者(n = 115)在治疗的前3周完成了抑郁(爱丁堡产后抑郁量表)、焦虑(广泛性焦虑障碍量表、产后焦虑筛查量表)和母婴联结(产后母婴联结问卷)测量。患者还匿名提供了项目满意度评分和定性反馈。
虽然焦虑和抑郁症状在不同服务环境中改善情况相似,但母婴联结仅在面对面治疗时显著改善。患者症状结果也因公共/私人保险、种族和子女数量而有所不同。患者对服务给予了高评分和总体满意度,现有反馈表明有些患者更倾向于面对面服务。
随着围产期心理健康服务和IOPs不断扩大,虚拟服务同样可以解决焦虑和抑郁症状,并有助于覆盖有需要的人群。然而,对于围产期IOPs,母婴联结这一核心治疗目标可能需要通过面对面服务来独特地实现。